Vertigo

Vertigo
Drawing showing the sensation of vertigo
Pronunciation
SpecialtyOtorhinolaryngology
SymptomsFeeling of spinning or swaying, vomiting, difficulty walking[1][2]
CausesBenign paroxysmal positional vertigo (BPPV), Ménière's disease, vestibular neuritis, stroke, brain tumors, brain injury, multiple sclerosis, migraine[1][2]
Differential diagnosisPresyncope, disequilibrium, non-specific dizziness[2]
Frequency20–40% at some point[3]

Vertigo is a condition in which a person has the sensation that they are moving, or that objects around them are moving, when they are not.[1] Often it feels like a spinning or swaying movement.[1][2] It may be associated with nausea, vomiting, perspiration, or difficulties walking.[2] It is typically worse when the head is moved.[2] Vertigo is the most common type of dizziness.[2]

The most common disorders that result in vertigo are benign paroxysmal positional vertigo (BPPV), Ménière's disease, and vestibular neuritis.[1][2] Less common causes include stroke, brain tumors, brain injury, multiple sclerosis, migraines, trauma, and uneven pressures between the middle ears.[2][4][5] Physiologic vertigo may occur following being exposed to motion for a prolonged period such as when on a ship or simply following spinning with the eyes closed.[6][7] Other causes may include toxin exposures such as to carbon monoxide, alcohol, or aspirin.[8] Vertigo typically indicates a problem in a part of the vestibular system.[2] Other causes of dizziness include presyncope, disequilibrium, and non-specific dizziness.[2]

Benign paroxysmal positional vertigo is more likely in someone who gets repeated episodes of vertigo with movement and is otherwise normal between these episodes.[9] Benign vertigo episodes generally last less than one minute.[2] The Dix-Hallpike test typically produces a period of rapid eye movements known as nystagmus in this condition.[1] In Ménière's disease there is often ringing in the ears, hearing loss, and the attacks of vertigo last more than twenty minutes.[9] In vestibular neuritis the onset of vertigo is sudden, and the nystagmus occurs even when the person has not been moving.[9] In this condition vertigo can last for days.[2] More severe causes should also be considered,[9] especially if other problems such as weakness, headache, double vision, or numbness occur.[2]

Dizziness affects approximately 20–40% of people at some point in time, while about 7.5–10% have vertigo.[3] About 5% have vertigo in a given year.[10] It becomes more common with age and affects women two to three times more often than men.[10] Vertigo accounts for about 2–3% of emergency department visits in the developed world.[10]

  1. ^ a b c d e f Post, RE; Dickerson, LM (2010). "Dizziness: a diagnostic approach". American Family Physician. 82 (4): 361–369. PMID 20704166. Archived from the original on 2013-06-06.
  2. ^ a b c d e f g h i j k l m n Hogue, JD (June 2015). "Office Evaluation of Dizziness". Primary Care: Clinics in Office Practice. 42 (2): 249–258. doi:10.1016/j.pop.2015.01.004. PMID 25979586.
  3. ^ a b von Brevern, M; Neuhauser, H (2011). "Epidemiological evidence for a link between vertigo & migraine". Journal of Vestibular Research. 21 (6): 299–304. doi:10.3233/VES-2011-0423. PMID 22348934.
  4. ^ Wicks, RE (January 1989). "Alternobaric vertigo: an aeromedical review". Aviation, Space, and Environmental Medicine. 60 (1): 67–72. PMID 2647073.
  5. ^ Buttaro, Terry Mahan; Trybulski, JoAnn; Polgar-Bailey, Patricia; Sandberg-Cook, Joanne (2012). Primary Care – E-Book: A Collaborative Practice (4 ed.). Elsevier Health Sciences. p. 354. ISBN 978-0323075855. Archived from the original on 2017-09-08.
  6. ^ Falvo, Donna R. (2014). Medical and psychosocial aspects of chronic illness and disability (5 ed.). Burlington, MA: Jones & Bartlett Learning. p. 273. ISBN 9781449694425. Archived from the original on 2015-07-02.
  7. ^ Wardlaw, Joanna M. (2008). Clinical neurology. London: Manson. p. 107. ISBN 9781840765182. Archived from the original on 2015-07-02.
  8. ^ Goebel, Joel A. (2008). Practical management of the dizzy patient (2nd ed.). Philadelphia: Lippincott Williams & Wilkins. p. 97. ISBN 9780781765626. Archived from the original on 2015-07-02.
  9. ^ a b c d Kerber, KA (2009). "Vertigo and dizziness in the emergency department". Emergency Medicine Clinics of North America. 27 (1): 39–50. doi:10.1016/j.emc.2008.09.002. PMC 2676794. PMID 19218018.
  10. ^ a b c Neuhauser HK, Lempert T (November 2009). "Vertigo: epidemiologic aspects" (PDF). Seminars in Neurology. 29 (5): 473–81. doi:10.1055/s-0029-1241043. PMID 19834858. S2CID 260318174.

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